CMS rescinds changes to zero dollar MSAs- for now

Last week I posted that CMS appeared to have altered the zero dollar MSA approval process. This caused a great deal of discussion and activity. This has resulted in CMS releasing the following bulletin indicating that no  changes will be made to the zero dollar MSA program until it publishes changes:

October 31, 2016 - Announcement regarding Current Workers’ Compensation Review Contractor Procedures and Request for Approval of Zero-Dollar Medicare Set-Aside Amounts

CMS recently received inquiries regarding procedural changes in the way that CMS’ Workers’ Compensation Review Contractor (WCRC) reviews proposed zero-dollar Workers’ Compensation Medicare Set-Aside Arrangement (WCMSA) amounts.  CMS determined changes had transpired without prior notification. Effective immediately, the WCRC will utilize procedures that were previously in effect.  CMS continually evaluates all policy and procedures related to WCMSA reviews and will publish any pending changes when or before they go into effect.

Therefore, we are in a “wait and see” holding pattern until CMS publishes some additional guidelines. The good news is that we can confirm CMS is approving zero dollar MSAs as expected under the current system. Sedgwick has been in touch with CMS and we will provide  feedback to CMS about how the proposed changes will adversely  affect the settlement process.

Please watch for additional updates as we continue to provide you with the most up to date information. Please feel free to leave questions or concerns here and I will do my best to answer your questions.


Michael R. Merlino II, ESQ. SVP of Medicare compliance and structured settlements Sedgwick

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